Instructions for use CIPROFLOXACIN-AKOS
Carefully:
the drug is prescribed to patients with cerebral atherosclerosis, cerebrovascular accident, and convulsive syndrome.
Special instructions:
the solution in the form of eye drops is not intended for intraocular injection! The drug should not be injected subconjunctivally or directly into the anterior chamber of the eye! When using other ophthalmic drugs, the interval between their administration should be at least 5 minutes.
If after using the drops conjunctival hyperemia continues for a long time or increases, then you should stop using the drug and consult a doctor.
As with other antimicrobial drugs, long-term treatment with this drug may lead to overgrowth of non-susceptible microorganisms, including fungi.
If signs of increased inflammation appear during treatment with the described drug, appropriate therapy is prescribed. Depending on the clinical picture, a scheme for examining the patient’s eye is determined, including examination under magnification using a biomicroscope, as well as fluorescein staining.
When the first signs of hypersensitivity appear, such as skin rash and others, treatment with ciprofloxacin is stopped immediately.
Patients using soft and hard contact lenses should stop wearing lenses during treatment with the drug.
To reduce systemic absorption after instilling the drug, keep the eyelid closed for 2 minutes; it is recommended to press the area of the lacrimal canal with your fingers for 2 minutes.
Caution should be exercised when using fluoroquinolones, including Ciprofloxacin, in patients with known risk factors for QT prolongation:
- congenital long QT interval syndrome;
- concomitant use of drugs that are known to prolong the QT interval (eg, class IA and III antiarrhythmic drugs, tricyclic antidepressants, macrolides, antipsychotics);
- electrolyte disturbances, especially uncorrected hypokalemia, hypomagnesemia;
- women and elderly patients are more sensitive to the effects of drugs that prolong the QT interval, such as Ciprofloxacin, so special caution is required;
- heart disease (eg, heart failure, myocardial infarction, bradycardia).
The ability of a drug to influence the behavior or functional parameters of the body, interaction with tobacco, alcohol, food:
- Patients who temporarily lose clarity of vision after application are not recommended to drive a car or work with complex machinery, machines or any complex equipment that requires clarity of vision immediately after instillation of the drug.
Ciprofloxacin-AKOS eye drops 0.3% 5 ml bottle 1 pc. in Moscow
A broad-spectrum antibacterial drug of the fluoroquinolone group for topical use in ophthalmology and ENT practice. Suppresses bacterial DNA gyrase (topoisomerases II and IV, responsible for the process of supercoiling of chromosomal DNA around nuclear RNA, which is necessary for reading genetic information), disrupts DNA synthesis, growth and division of bacteria. Causes pronounced morphological changes (including cell wall and membranes) and rapid death of the bacterial cell.
It has a bactericidal effect on gram-negative organisms during the period of rest and division (since it affects not only DNA gyrase, but also causes lysis of the cell wall), on gram-positive microorganisms - only during the period of division.
Low toxicity for the cells of the macroorganism is explained by the absence of DNA gyrase in them. While taking ciprofloxacin, there is no parallel development of resistance to other actibiotics that do not belong to the group of gyrase inhibitors, which makes it highly effective against bacteria that are resistant, for example, to aminoglycosides, penicillins, cephalosporins, tetracyclines and many other antibiotics.
Active against gram-negative aerobic bacteria: Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Klebsiella spp., Enterobacter spp., Proteus mirabilis, Proteus vulgaris, Serratia marcescens, Hafnia alvei, Edwardsiella tarda, Providencia spp., Morganella morganii, Vibrio spp., Yersinia spp., Haemophilus spp., Pseudomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida, Plesiomonas shigelloides, Campylobacter jejuni, Neisseria spp.;
gram-positive aerobic bacteria:
Staphylococcus spp.
(Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus), Streptococcus spp. (Streptococcus pyogenes, Streptococcus agalactiae); some intracellular pathogens:
Legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Corynebacterium diphtheriae.
Moderately sensitive to ciprofloxacin (high concentrations are required to suppress them) Streptococcus pneumoniae, Enterococcus faecalis, Mycobacterium avium (located intracellularly).
Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides are resistant to ciprofloxacin
Most staphylococci resistant to methicillin are also resistant to ciprofloxacin.
Not effective against Treponema pallidum.
Resistance develops extremely slowly: on the one hand, after the action of ciprofloxacin there are practically no persistent microorganisms left, on the other hand, bacterial cells do not have enzymes that inactivate it.
Ciprofloxacin
Ciprofloxacin
(lat.
Ciprofloxacin
) - a broad-spectrum antibiotic, an antibacterial agent of the 2nd generation fluoroquinolones group.
Ciprofloxacin is a chemical substance
Ciprofloxacin is a pale, slightly yellowish crystalline powder. Ciprofloxacin is practically insoluble in water and ethanol Chemical name of ciprofloxacin: 1-Cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinolinecarboxylic acid (and as hydrochloride). Empirical formula: C17H18FN3O3.
Ciprofloxacin is a medicine
Ciprofloxacin is the international nonproprietary name (INN) of the drug. According to the pharmacological index, ciprofloxacin belongs to the group “Quinolones/fluoroquinolones”. According to ATC, ciprofloxacin is included in the group “J01 Antibacterial drugs for systemic use”, the subgroup “J01MA Fluoroquinolones” and has the code J01MA02. Eye and ear drops "Ciprofloxacin" belong to two groups of the pharmacological index: "Quinolones/fluoroquinolones" and "Ophthalmic agents", and according to ATC - to the group "S01 Preparations for the treatment of eye diseases" and has the code S01AX13 or to the group "S03 Preparations for treatment of ophthalmological and otological diseases" and then has the code S03AA07. Ciprofloxacin is also the trade name of the drug.
Indications for use of ciprofloxacin
Ciprofloxacin is indicated for infectious and inflammatory diseases caused by microorganisms sensitive to ciprofloxacin, including diseases of the respiratory tract, abdominal cavity and pelvic organs, bones, joints, skin;
with septicemia; for severe infections of the ENT organs, in the treatment of postoperative infections, for the prevention and treatment of infections in patients with reduced immunity. Ciprofloxacin is indicated for topical use in acute and subacute conjunctivitis, blepharoconjunctivitis, blepharitis, bacterial corneal ulcers, keratitis, keratoconjunctivitis, chronic dacryocystitis, meibomitis, and infectious eye lesions after injury or foreign bodies. Preoperative prophylaxis in ophthalmic surgery.
WHO recommends taking ciprofloxacin (three days 500 mg twice daily for adults, 15 mg/kg twice daily for children) if a traveler experiences diarrhea with very frequent, very loose or bloody stools lasting more than three days and the sick person has no access to medical care (Safe food guide for tourists. What to do if you have diarrhea?). WHO also recommends ciprofloxacin as the antibiotic of choice; when treating dysentery caused by Shigella in adults and children, take the same dosage for three days (“Treatment of diarrhea.” WHO, 2006).
Microorganisms against which ciprofloxacin is active or inactive
The following microorganisms are sensitive to ciprofloxacin:
- enterobacteria Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Klebsiella spp.
( including
Klebsiella oxytoca
), Enterobacter spp. - other gram-negative bacteria: Proteus mirabilis, Proteus vulgaris, Serratia marcescens, Hafnia alvei, Edwardsiella tarda, Providencia spp., Morganella morganii, Vibrio spp., Yersinia spp., Haemophilus spp., Pseudomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida , Plesiomonas shigelloides, Campylobacter jejuni, Neisseria spp.
- intracellular pathogens: Legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Mycobacterium avium-intracellulare
- gram-positive aerobic bacteria: Staphylococcus spp. (Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus), Streptococcus spp. (Streptococcus pyogenes, Streptococcus agalactiae).
- Most methicillin-resistant staphylococci are also resistant to ciprofloxacin.
Streptococcus pneumoniae and Enterococcus faecalis
are moderately sensitive to ciprofloxacin .
Corynebacterium spp., Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides are resistant to ciprofloxacin
On the website gastroscan.ru in the literature catalog there is a section “Antibiotics used in the treatment of gastrointestinal diseases”, containing articles on the use of antimicrobial agents in the treatment of diseases of the digestive tract.
FDA warning about serious side effects of fluoroquinolones
On July 26, 2016, the FDA issued a warning that fluoroquinolones, namely ciprofloxacin, extended-release ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin and ofloxacin, approved for use in the United States, have a large number of serious side effects when used systemically, including: inflammation of tendon tissue, tendon rupture, numbness or tingling, muscle weakness, muscle pain, joint pain, swollen joints, anxiety, depression, hallucinations, mental confusion, suicidal thoughts, exacerbation of myasthenia gravis, rash, sunburn, abnormal, fast or strong heartbeat, severe diarrhea.
The FDA notes that the risks of using fluoroquinolones in the treatment of acute sinusitis, bronchitis, and uncomplicated urinary tract infections most often outweigh their potential benefits. At the same time, it is emphasized that in the treatment of anthrax, plague, and bacterial pneumonia, the benefits of using fluoroquinolones are beyond doubt.
The FDA considers an overall reduction in fluoroquinolone consumption to be important.
Use of ciprofloxacin during pregnancy, breastfeeding and children
Pregnant women should only take ciprofloxacin if absolutely necessary.
Ciprofloxacin passes through the placenta. Ciprofloxacin FDA Fetal Category C (Animal studies have shown adverse effects on the fetus and there have been no adequate studies in pregnant women, but the potential benefits associated with this drug may justify its use despite the risks). Ciprofloxacin is contraindicated during breastfeeding and in children under 15 years of age.
Trade names of drugs with the active substance ciprofloxacin
Alcipro, Afenoxin, Basijen, Betaciprol, Vero-Ciprofloxacin, Zindolin 250, Ificipro, Quintor, Quipro, Liproquin, Microflox, Procipro, Recipro, Siflox, Tseprova, Ciloxan, Cypraz, Cyprinol, Cyprinol, Ciprobay, Ciprobid, Ciprobrin, Ciprodox, Ciprolacare , Ciprolet, Ciprolon, Cipromed, Cipropan, Ciprosan, Ciprosin, Ciprosol, Ciprofloxabol, Ciprofloxacin, Ciprofloxacin bufus, Ciprofloxacin-AKOS, Ciprofloxacin-Promed, Ciprofloxacin-FPO, Ciprofloxacin hydrochloride, Ciprofloxacin hydrochloride film-coated tablets, Citeral, Cifloxinal , Tsifran, Tsifran OD, Ecotsifol.
Brands of ciprofloxacin in the USA: Cipro, Cipro XR, Proquin XR, Cipro IV, Cipro Cystitis Pack.
In total, more than a hundred generics of ciprofloxacin are produced in the world.
Instructions for US patients (in English, pdf): “Medication Guide. CIPRO ® (ciprofloxacin hydrochloride) Tablets for oral use. CIPRO ® (ciprofloxacin hydrochloride) for oral suspension. CIPRO ® XP (ciprofloxacin hydrochloride) Tablets for oral use. CIPRO ® IV (ciprofloxacin hydrochloride) Injection for intravenous infusion.” Bayer HealthCare Pharmaceuticals Inc. July 2016
general information
Ciprofloxacin is a medicine sold both in Russia and in the USA and EU countries from pharmacies with a prescription.
Ciprofloxacin causes acute pancreatitis in approximately 3% of patients, which resolves after stopping the drug (Sung HY et al, Gut Liver, 2014 May).
Ciprofloxacin has contraindications, side effects and application features; consultation with a specialist is necessary.
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